Free Healthcare IT Newsletter Want to receive the latest news on EMR, Meaningful Use,
ARRA and Healthcare IT sent straight to your email? Get all the latest Health IT updates from Neil Versel for FREE!

Email Address:

We never sell or give out your contact information.
We respect our readers' privacy.

Last week, digital health accelerator Rock Health unveiled its new offices, and from the news coverage, it seems as if it’s creating an image as much as incubating startup companies.

According to Xconomy, “a big crowd of investors, executives, and other life science industry insiders took time away from JP Morgan to attend the grand opening of Rock Health’s stylish new headquarters in the Mission Bay neighborhood of San Francisco.” And stylish it is.

“Rock Health’s kitchen and community gathering space includes a Cirque-du-Soleil-style swing,” Xconomy reported. Because, you know, incubating companies that will fix a broken $2.8 trillion industry with their “solutions” requires a little avant-garde spectacle à la Québécoise — or perhaps Las Vegas. Having been at the Digital Health Summit at International CES in Sin City myself a week earlier, I was happy to see more focus on substance than style in the meeting room, if not in the exhibit hall.

I bet that swing cost a lot of money. So did the design, since Xconomy saw fit to identify the architecture firm. (For that matter, so did I, but only to give proper credit for the photo.) In an industry where a third or more of spending is wasteful — completely irrelevant to care and probably preventable — according to a 2012 report in Health Affairs, are such frills really necessary? I’m certainly not blaming Rock Health here. It’s the investors who are throwing away their money.

In opening the center, Rock Health reportedly dubbed Mission Bay the ‘United States’ New Digital Health Hub.'” That’s a bold statement. There certainly is a lot of potential there, but, as the person who identified San Diego as “a leader in mobile healthcare” back in January 2010, I still see more substance and tangible results in Southern California than in Northern California. For that matter, the Boston area could make a strong case, as could New York City. Smaller but healthy communities have popped up in places like Madison, Wis. That’s fine, competition is good.

However, I’ve seen more failures in Silicon Valley than anywhere else. But does that stop Silicon Valley’s No. 1 media cheerleader, TechCrunch, from declaring, “VC’s Investing To Heal U.S. Healthcare”? No, it does not.

No flame-out has been as spectacular as that overhyped vaporware known as Google Health. Google is back at it again with its VC arm, but this time the Internet giant seems to have a direction and a clue. Maybe.

As TechCrunch reported, “Google Ventures is addressing the nation’s healthcare dilemma with investments in companies like the physicians’ office and network One Medical Group, which raised a later stage $30 million last March. At the opposite end of the spectrum in December 2013 Google invested in the $3 million seed financing of Doctor on Demand, which sells a service enabling users to video chat with doctors.”

Google appears to be scrapping the torturous direct-to-consumer route in favor of going where the money actually is, from third-party payers and from providers, newly incented under the Patient Protection and Affordable Care Act and private reform efforts to work more efficiently and better coordinate care.

On the other hand, it’s been less than two weeks since Stephen Colbert made fun of Doctor on Demand. (Health 2.0 boss Matthew Holt commented on that post that it was “Kind of unfair that Doctor on Demand get the publicity when American Well and a [scad] of others have been doing this at scale for years.” He was right, but, hey, Google.)

Google Venture General Partner Dr. Krishna Yeshwant told TechCrunch the real motive behind all the VC money flooding into healthcare. “As an entity it is where we’re spending 17 percent to 18 percent of GDP, so any one segment is tens of billions of dollars,” Yeshwant is quoted as saying. “Increasingly you’re seeing IT investors who have a fine sense of disruptive opportunities enter the market.” In other words, it’s all about the Benjamins.

But do they understand that healthcare doesn’t work like any other industry? I’m not so sure. And I haven’t even addressed the bigger questions of privacy, data stewardship, interoperability and workflow.

As you prepare your hate mail for me, check out this site, “What the F*** Is My Wearable Strategy?” (NSFW). Refresh the page for more hilarity, but be forewarned: some of the ideas may hit close to home.

Healthcare Technology Online reports this week that there is a new comic strip online called Hacking N’ Healthcare. “Hacking N’ Healthcare is a comic strip that takes a humorous look at the challenges often associated with implementing health information technology,” the magazine says. Here’s what appears to be the first edition, taking a swing at user experience design, but also, perhaps inadvertently, mocking personal health records and gamification in healthcare. (The timing is interesting. In a MobiHealthNews column that should be published Friday, I take the most measured, hopeful look at PHRs that I have since about 2007.)

Hacking ‘N Healthcare (from Health Technology Online)

I can’t determine if Healthcare Technology Online or Pathfinder Software is the source of this comic, or if it’s going to be a regular feature in either place. I Googled “Hacking ‘N Healthcare” and found nothing relevant. And speaking of fails, there is no word in the English language spelled “sceptor.” It’s “scepter” in American English and “sceptre” in the Queen’s English. Did I mention I’m available for all your editing needs?

As promised, there is some video from the “Meet the Bloggers” panel I appeared on, and it comes to us from Dr. Chuck Webster of EHR Workflow Inc. and the EHR.BZ Report. (You may know him from his previous job as CMIO of EHR vendor EncounterPro, formerly known as JMJ Technologies.) Webster was there in the front row capturing parts of the session with a Bluetooth camera strapped to his hat.

For the record, I do not use Google+. I have an account, and some readers have added me to their circles, but I have not posted a single word there. Google’s terms of service—both old and new—essentially gives the Don’t Be Evil company the right to use my content in any way it sees fit. From “Your Content in our Services”:

Some of our Services allow you to submit content. You retain ownership of any intellectual property rights that you hold in that content. In short, what belongs to you stays yours.

When you upload or otherwise submit content to our Services, you give Google (and those we work with) a worldwide license to use, host, store, reproduce, modify, create derivative works (such as those resulting from translations, adaptations or other changes we make so that your content works better with our Services), communicate, publish, publicly perform, publicly display and distribute such content. The rights you grant in this license are for the limited purpose of operating, promoting, and improving our Services, and to develop new ones. This license continues even if you stop using our Services (for example, for a business listing you have added to Google Maps). Some Services may offer you ways to access and remove content that has been provided to that Service. Also, in some of our Services, there are terms or settings that narrow the scope of our use of the content submitted in those Services. Make sure you have the necessary rights to grant us this license for any content that you submit to our Services.

You can find more information about how Google uses and stores content in the privacy policy or additional terms for particular Services. If you submit feedback or suggestions about our Services, we may use your feedback or suggestions without obligation to you.

As someone who makes a living creating content, this scares me. Google effectively can steal and modify my content without compensation. No, thanks.

I also should give a belated shout-out to Joe Paduda of Managed Care Matters, who hosted last week’s Health Wonk Review. My HIMSS12 wrap made the review of healthcare news from the blogosphere.

Monday plenary sessions: [blackbirdpie url=”http://twitter.com/#!/nversel/status/118362364071518208″] This got someone from HealthTap to misinterpret what I had said: [blackbirdpie url=”http://twitter.com/#!/HealthTap/status/118365108513673216″] To which I replied: [blackbirdpie url=”http://twitter.com/#!/nversel/status/118365613512073216″] (For the record, @CHCF is not the correct handle for the California HealthCare Foundation. It’s @CHCFnews.)

I also had an important question for HealthTap, one that so far has gone unanswered. [blackbirdpie url=”http://twitter.com/#!/nversel/status/118363924281303040″]

I found quite a bit of news and lack of news being announced on stage. [blackbirdpie url=”http://twitter.com/#!/nversel/status/118383509172793344″] [blackbirdpie url=”http://twitter.com/#!/nversel/status/118384168316059649″]

And don’t take kindly to vagueness about the word “solution.” [blackbirdpie url=”http://twitter.com/#!/nversel/status/118390936257560576″] [blackbirdpie url=”http://twitter.com/#!/nversel/status/118391125554892800″] [blackbirdpie url=”http://twitter.com/#!/grapealope/status/118391490748743680″] [blackbirdpie url=”http://twitter.com/#!/nversel/status/118393697674067968″] [blackbirdpie url=”http://twitter.com/#!/grapealope/status/118394480213766144″] (I get the sense @grapealope is among the many Silicon Valley cheerleaders who came not to a conference but a pep rally. I bet the Kool-Aid tasted great.)

Then came the lamest presentation of them all, in a plenary session no less, a demo of an overly cutesy “life game” called Mindbloom. The presentation was accompanied by distracting sound effects of birds chirping the entire time, and the game itself featured a guide character called the “enlightening bug.” My impression? [blackbirdpie url=”http://twitter.com/#!/nversel/status/118492715196497920″]

Others weren’t so harsh, but at least had questions about the purpose and appeal. [blackbirdpie url=”http://twitter.com/#!/pjmachado/status/118492523277729793″] [blackbirdpie url=”http://twitter.com/#!/nversel/status/118492973959888896″] [blackbirdpie url=”http://twitter.com/#!/pjmachado/status/118493232614215680″] [blackbirdpie url=”http://twitter.com/#!/nversel/status/118493422821715968″]

I later asked fellow realist John Moore of Chilmark Research this question: [blackbirdpie url=”http://twitter.com/#!/nversel/status/118498456888279040″]

At least I wasn’t the only one worn out by having to separate the wheat from the chaff. [blackbirdpie url=”http://twitter.com/#!/familyhealthguy/status/118479710656278529″]

I did tone down my rhetoric a bit on Tuesday, though. [blackbirdpie url=”http://twitter.com/#!/nversel/status/118569075063529472″]

OK, maybe only a bit, especially after Microsoft’s Mike Raymer said, “It was good to have two companies create a marketplace,” in reference to Microsoft’s HealthVault and the soon-to-be-departed Google Health. [blackbirdpie url=”http://twitter.com/#!/nversel/status/118799888640258048″] [blackbirdpie url=”http://twitter.com/#!/nversel/status/118800555463290880″]

I highlighted what I saw as good points: [blackbirdpie url=”http://twitter.com/#!/2healthguru/status/118706082238562305″] [blackbirdpie url=”http://twitter.com/#!/nversel/status/118706473646817281″]

And I asked a question that I’d love to hear an answer to: [blackbirdpie url=”http://twitter.com/#!/nversel/status/118801288849920002″]

I would be less likely to tune out certain sessions if there were more related to healthcare and less to personal fitness and wellness. Of course, others have different viewpoints, which is why it might make more sense to separate the two into different conferences or at least different tracks.

In case you were still of the opinion that Google and Microsoft were the major players and groundbreaking pioneers of personal health records, here’s a partial list of other companies that have been at it for at least as long. I believe CapMed goes back as far as 1991. Some have been bought by larger firms, but many are still independent.

Clip and save, or pass on to your favorite tech journalist that got snookered by the Google PR machine.

In any case, I remain unconvinced that the direct-to-consumer, “untethered” model—no connection to an electronic medical record unless the patient sets it up that way (and really, can any EMR today be configured like that anyway)—can grab more than a small subset of data geeks as customers.

Remember back in February when I cut my face open at the HIMSS conference and needed medical assistance while 1,000 miles from home? I blogged then about how I used Google Maps to find an urgent care clinic close to the convention center instead of riding to a hospital emergency room in an ambulance? I’m guessing that course of action saved me at least $1,500, money that would have come out of my pocket because, as a self-employed individual, I was only able to qualify for an afford an insurance policy with a high deductible.

Though most Americans still aren’t engaged as consumers when they seek healthcare services, there are tens of millions of uninsured people and a smaller number of people like me with high-deductible plans that would face the same conundrum when they have a non-life-threatening condition: go for “traditional” ER care and pay through the nose, or take a few minutes to seek out lower-cost alternatives.

Now, insurers are trying to encourage the same kind of behavior, because they usually are the ones on the hook for high-dollar ambulance transport and emergency care, even if the condition isn’t a true emergency. Last week, Anthem Blue Cross in California announced a new program to encourage members to seek out non-emergency care—walk-in retail clinics and urgent care centers—when their regular physicians are not available.

“When your five-year-old is crying with a fever at 7 p.m. on a Friday because she has a sore throat or an ear ache, what do you do?” Anthem Medical Director Kurt Tamaru, M.D., said in a press release. “It’s important people know that they have options for less serious ailments other than an ER, such as retail health clinics and urgent care centers that provide quality care and cost them significantly less.”

According to Anthem Blue Cross, an ER charges an average of $641 treat strep throat, something that would cost about $70 at an urgent care center and just $27 at a retail health clinic. This does effect patients directly, too, because Anthem requires a $150 co-pay on average for a ER visit, but just $10 to $40 for care delivered at a walk-in clinic or urgent care center.

The technology driving this program? Google Maps and its brethren.

Just go to Google, Yahoo or Bing and type in “Anthem and urgent care,” and you will be directed to an Anthem educational site (or visit the site directly at http://www.anthem.com/ca/eralt). There, you will find a Google map showing ER alternatives within Anthem’s California network.

Members can sign up for educational e-mails explaining the types of conditions that don’t usually require emergency care, and the potential costs savings by seeking an alternative. Anthem also will make automated phone calls to members who recently had a costly ER visit that could have been avoided.

Anthem cited a study that proved the efficacy of such as an approach. Hopefully, the statistics are accurate and Anthem has success with its program. It worked for me because a lot of money was on the line. Likewise, Anthem members now face higher out-of-pocket expenses if they choose the expensive option rather than the right option. And all it takes is a simple, proven piece of technology called Google Maps.

It’s official, Google is in fact walking away from Google Health, the way overhyped, way underused personal health record platform. In a posting on the Google Blog today, Aaron Brown, Google Health’s senior product manager, said the company would “retire” Google Health Jan. 1, 2012. (Data will be available to download until Jan. 1, 2013.)

Google also decided to wind down another experiment, Google PowerMeter.

From the post:

When we launched Google Health, our goal was to create a service that would give people access to their personal health and wellness information. We wanted to translate our successful consumer-centered approach from other domains to healthcare and have a real impact on the day-to-day health experiences of millions of our users.

Now, with a few years of experience, we’ve observed that Google Health is not having the broad impact that we hoped it would. There has been adoption among certain groups of users like tech-savvy patients and their caregivers, and more recently fitness and wellness enthusiasts. But we haven’t found a way to translate that limited usage into widespread adoption in the daily health routines of millions of people. That’s why we’ve made the difficult decision to discontinue the Google Health service.

…

In the end, while we weren’t able to create the impact we wanted with Google Health, we hope it has raised the visibility of the role of the empowered consumer in their own care. We continue to be strong believers in the role information plays in healthcare and in improving the way people manage their health, and we’re always working to improve our search quality for the millions of users who come to Google every day to get answers to their health and wellness queries.

Google said it soon will install functionality to help current PHR users migrate their data to other services following the Direct Project protocol, in the spirit of “data liberation.” That’s nice, but data really needs to connect with EHRs, or doctors and patients simply won’t use PHRs. Period.

I’m also going to take issue with Google referring to Google Health and Google PowerMeter as “trailblazers in their respective categories.” Google didn’t blaze any trails in PHRs. Dozens of other, smaller companies that have been working on the concept of PHRs for a decade or more are the real trailblazers.

The bottom line on Google Health? Google came into healthcare arrogantly believing it could save healthcare from itself and be all things to all people. (See also: WebMD, circa 2001.) It leaves with its tail between its legs.

Healthcare really does need disruptive outside forces, but it has to be a product people want to use. The iPad qualifies. Google Health never did, nor has any other untethered PHR to date.

Has this been reported before, or have I just not been paying close enough attention?

Yesterday at the Mobile Health Expo in New York, Sean Handel, vice president of subscriber business at Epocrates, said that the San Mateo, Calif.-based company known for its mobile medical reference tools, is building an EHR for small physician practices. “A significant portion of that product will be a patient portal,” Handel said.

Handel also said to expect to see more integration of mobile apps into clinical systems as more people shift to tablets from traditional PCs. That’s no surprise. We have so little integration now that it really can only go up.

While I’m being slightly cynical, I leave you with this thought from Google’s Dr. Roni Zeiger:

You may have heard news of Google essentially putting its Google Health PHR platform in cold storage. Whether it’s true or not, the “untethered” PHR—one not connected to a health system’s EHR—has been a non-starter for years. I’ve been particularly critical of the undeserved attention Google Health and Microsoft HealthVault have received, when many smaller companies have been working on PHRs for much longer.

The original head of the Google Health project, Adam Bosworth, left the company in 2007 under suspicious circumstances—did he quit or was fired?—prior to the way overhyped 2008 introduction of this vaporware. Bosworth has gone on to start a new company, Keas, that produces a PHR that incorporates care plans. Keas got some undeserved hype itself, in the form of an October 2009 story in the New York Times that, from what I understand, was suggested by a Times editor who also was advising Keas. (That editor is no longer with the Times.)

Keas itself hasn’t gained much traction, either. I reported in September 2010 that Keas abandoned its original plans to sell direct to consumers in favor of partnering with insurance companies and large employers. That was the last I had heard about Keas until last week, when TechCrunch TV posted the following short interview with Bosworth, entitled, “Adam Bosworth On Why Google Health Failed”:

Bosworth said that Google simply didn’t offer anything the public really wanted. “They basically offered a place to store data,” he said. “Our data shows people don’t really want a place to store data per se. They want to do something fun and engaging. If it’s not fun, if it’s not social, why would they do it?” Yes, that makes sense.

Bosworth said that people need encouragement and even peer pressure to practice healthy behaviors. Bosworth said he lost 22 pounds in 18 weeks by walking 4 miles each way to and from his downtown San Francisco office four times a week, and he credited the encouragement he got from checking in on Keas.

That’s a great sign, but I wonder how many other stories like his there are out there? My guess is, not many. I’m thinking online communities of like-minded people or those facing similar health issues have been far more successful. Last night’s post is a prime example.

Free Healthcare IT Newsletter Want to receive the latest news on EMR, Meaningful Use,
ARRA and Healthcare IT sent straight to your email? Get all the latest Health IT updates from Neil Versel for FREE!

Email Address:

We never sell or give out your contact information. We respect our readers' privacy.